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Unit I: Foundations of Community Health

Chapter 1 Ahmad adeeb

MsN.CCRN.RN

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Introduction

In this unit the foundations for community health nursing are presented. Basic information about the definition and description of a community; the preparation for working in this discipline; the function, roles and settings for community health nursing; culture, ethics and values to consider in the community; and the structure, function and financing of health care is focused on in this unit.

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Chapter 1

Community Health Nursing Opportunities and Challenges

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Objectives:

Upon mastery of this chapter, you should be able to:

Define community health and distinguish it from public health.

Explain the concept of community.

Describe three types of communities.

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Objectives:

Diagram the health continuum.

Differentiate among the three levels of prevention.

Analyze the six components of community health practice.

Describe the eight characteristics of community health nursing.

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Concept of Community

…collection of people who interact with one another and whose common interests or characteristics form the basis for a sense of unity or belonging

List some communities:

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Community Health (CH) and Public Health (PH)

CH = “identification of needs and the protection and improvement of collective health within a geographically defined area”

PH = “activities that society undertakes to assure the conditions in which people can be healthy”

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Three Types of Communities

1- Geographic = city, town, neighborhood

2- Common-interest = professional organization, people with mastectomies

3- Community of solution = group of people who come together to solve a problem that affects all of them

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Example of Communities of Solution

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Wellness-Illness continuum

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Six Components of Community Health Practice

1- Promotion of health

2- Prevention of health problems

3- Treatment of disorders

4- Rehabilitation

5- Evaluation

6- Research

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Health Promotion

All efforts that seek to move people closer to optimal well-being or higher levels of wellness

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Levels of Prevention:

PrimaryKeep illness or injury from occurring

SecondaryEfforts to detect and treat existing disease

TertiaryReduce the extent and severity of a health problem to its lowest possible level to minimize disability and restore or preserve function

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Describe Eight Characteristics of Community Health Nursing

1- Field of nursing:

shift from individual to aggregate (public)

2- Combines public health with nursing

Community-based & population focused

Public health sciences & nursing theory

3- Population focused

4- Emphasizes prevention

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Describe Eight Characteristics of Community Health Nursing

5- Promotes client responsibility & self-care

6- Use aggregate assessment measurement & analysis

7- Uses principles of organizational theory

8- Involves inter-professional collaboration

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END OF PART ONE …

BYE….

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Unit I: Foundations of Community Health

Chapter 2Evolution of Community Health Nursing

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Objectives:

Upon mastery of this chapter, you should be able to:Describe the four stages of community health nursing’s development.Analyze the impact of societal influences on the development and practice of community health nursing.Recognize the contributions of selected nursing leaders throughout history to the advancement of community health nursing.Explore the academic and advanced professional preparation of community health nurses.

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Describe the four stages of community health development

Early Home Care (before Mid-1800s)

District (local) Nursing (Mid-1800s to 1900)

Public Health Nursing (1900 – 1970)

Community Health Nursing (1970 – present)

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Early home care (before Mid-1800s)

Religious and charitable groups

Elizabethan Poor Law

St. Vincent de Paul

Home deliveries

Industrial revolution

Florence Nightingale & Mary Seacole

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District Nursing (Mid-1800s to 1900)

Visiting Nursing (district nursing)

Care of individuals

Religious to private philanthropy

Health visitors backbone of primary health care system

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Public Health Nursing (1900 – 1970)

Expansion to health & welfare of the general public

Specialized programs

Lillian Wald: Public Health NursingTeachers College

National Organization for Public Health Nursing

Henry Street Settlement

National League of Nursing Education

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Community Health Nursing (1970 – present)

Community Health NursingPublic Health Nursing (Epidemiology)

Community-based clinics

Work Sites

Schools

Collaboration and interdisciplinary teamwork

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Analyze the impact of societal influences on CHN

Advanced technology

Causal thinking

Educational changes

Role changes for women

Consumer movement & changing demographics

Economic forces

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Identify five characteristics shared by all cultures

1- Learned

2- Integrated

3- Shared

4- Mostly tacit

5- Dynamic

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Case Study:

Assume that you have been asked to make a home visit to a 75-year-old man living alone whose wife recently died.

Besides assessing his individual needs, what additional factors should you consider for assessment and intervention that would indicate an aggregate or population-focused approach?

What self-care practices might you encourage or teach?

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Internet Resources

American Academy of Nursing: http://www.nursingworld.org/aan American Assembly for Men in Nursing: http://www.aamn.org American Nurses Association: http://www.ana.org American Nurses Credentialing Center: http://www.nursingworld.org/ancc/index.html American Nursing Informatics Association: http://www.ania.org American Public Health Association: http://www.apha.org

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Internet Resources

National Association of Hispanic Nurses: http://www.nahnhq.org

National Center for Health Statistics: http://www.cdc.gov/hchc

National League for Nursing: http://www.nln.org

Sigma Theta Tau International Honor Society of Nursing: http://www.nursingsociety.org

U.S. Department of Labor. Bureau of Labor Statistics: http://www.bls.gov

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END OF PART TWO…

BYE….

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Unit I: Foundations of Community Health

Chapter 3Roles and Settings for CHN

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Objectives:

Upon mastery of this chapter, you should be able to:

● Identify the three core public health functions basic to community among seven different roles of the community health nurse.

● Discuss the seven roles within the framework of public health nursing functions.

● Explain the importance of each role for influencing people’s health.

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Objectives:

● Identify and discuss factors that affect a nurse’s selection and practice of each role.

● Describe seven settings in which community health nurses practice.

● Discuss the nature of community health nursing, and the common threads basic to its practice, woven throughout all roles and settings.

● Identify principles of sound nursing practice in the community.

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Three Core PH Functions

1) AssessmentRegular collection, analysis and sharing of information about health conditions, risks and resources in a community

2) Policy DevelopmentUse of assessment data to develop policy and direct resources toward those policies

3) AssuranceAvailability of necessary services throughout the community

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Seven Roles & Influence on People’s Health

1- Clinician: focus on holism, health promotion, & prevention while using expanded skills

2- Educator: plan for community-wide impact

3- Advocate: Support client self-determination and responsive systems

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How Roles & Factors Influence People’s Health

4- Manager: Participative approach with community

5- Collaborator: multidisciplinary collegiality and leadership

6- Leadership: Change agent

7- Researcher: Systematic investigation, collection, and analysis of data for solving problems and bring evidence-based findings to community settings

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Seven PHN Settings

I. Homes

II. Ambulatory Service

III. Schools

IV. Occupational Health

V. Residential Institutions

VI. Parishes

VII. Community at Large

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Nature & Common Threads Basic to Practice

Many nursing roles Special skill sets

AssessmentPolicy DevelopmentAssurance

Variety of clients in specific situationsCollaboration with other institutions

Schools & ParishesOccupational Health

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Principles of Sound Community Nursing Practice

Standards of practiceStandards of careManagement essential to all nursing roles

Community Nursing Process: assessment, planning, implementation, & evaluationCase management

Essential BehaviorsDecision-makingTransferring informationRelationship building

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Internet Resources

A Day in the Life of Public Healthhttp://www.apha.org/career/dayinlife.htm

Public Health Nursing Section of APHAhttp://www.csuchico.edu/~horst/

Ten Essential Services of Public Health http://www.apha.org/ppp/science/10ES.htm

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TANK YOU ….